Fluid therapy based on adjusted urine output rate, and associated systems, devices, and methods

Abstract

This present disclosure relates to fluid therapy based on adjusted urine output rate and/or sodium output rate, and associated systems, devices, and methods. Exemplary methods can include receiving a sodium excretion input for the patient; receiving a urine output rate; determining an adjusted urine output rate based on the sodium excretion input and the urine output rate; and providing fluid therapy based on the adjusted urine output rate. By determining the amount and/or rate of the infused diuretic and/or hydration fluid based on a patient's actual sodium excretion levels, embodiments of the present technology can optimize and/or customize all or a subset of a diuretic therapy to an individual patient's physiology.

We claim: 
     
         1 . A fluid therapy system, comprising:
 a urine measurement device configured to measure urine output of a patient;   a diuretic source configured to provide a diuretic to the patient;   a hydration fluid source configured to provide a hydration fluid to the patient; and   a controller, wherein the controller is configured to—
 obtain, via the urine measurement device, a urine output rate of the patient; 
 obtain a sodium excretion input for the patient; 
 determine an adjusted urine output rate based on the sodium excretion input and the urine output rate, comprising—
 dividing the sodium excretion input by a predetermined urine sodium concentration to produce a weighted value, and 
 multiplying the weighted value by the urine output rate to determine the adjusted urine output rate; and 
 
 based on the adjusted urine output rate, (i) cause the diuretic to be administered to the patient at one or more diuretic dosage rates and (ii) cause the hydration fluid to be administered to the patient at one or more hydration rates to produce a net fluid loss in the patient. 
   
     
     
         2 . The fluid therapy system of  claim 1 , wherein the controller is further configured to:
 determine, based at least in part on a ratio of the urine output rate to the adjusted urine output rate, one or more thresholds associated with the administration of the hydration fluid and/or the diuretic to the patient; and   cause the diuretic and/or the hydration fluid to be administered, and/or cause an adjustment to the one or more diuretic dosage rates and/or the one or more hydration rates, based at least in part on the one or more thresholds.   
     
     
         3 . The fluid therapy system of  claim 1 , wherein the predetermined urine sodium concentration is at least 140 mmol/L. 
     
     
         4 . The fluid therapy system of  claim 1 , wherein
 the predetermined urine sodium concentration is a predetermined urine sodium concentration for a group of patients.   
     
     
         5 . The fluid therapy system of  claim 1 , wherein, to determine the adjusted urine output rate, the controller is further configured to:
 determine the sodium excretion input is greater than a max threshold urine sodium level, and   use the max threshold urine sodium level as the sodium excretion input for the purpose of determining the adjusted urine output rate.   
     
     
         6 . The fluid therapy system of  claim 1 , wherein, to determine the adjusted urine output rate, the controller is further configured to:
 determine the sodium excretion input is less than a minimum threshold urine sodium level, and   use the minimum threshold urine sodium level as the sodium excretion input for the purpose of determining the adjusted urine output rate.   
     
     
         7 . The fluid therapy system of  claim 1 , wherein:
 before receiving the sodium excretion input, the controller is configured to provide the hydration fluid at a hydration fluid infusion rate; and   after receiving the sodium excretion input, the controller is configured to adjust the hydration fluid infusion rate based on the adjusted urine output rate.   
     
     
         8 . The fluid therapy system of  claim 1 , wherein:
 before receiving the sodium excretion input, the controller is configured to provide the diuretic at a diuretic dosage rate; and   after receiving the sodium excretion input, the controller is configured to adjust the diuretic dosage rate based on the adjusted urine output rate.   
     
     
         9 . The fluid therapy system of  claim 1 , wherein the sodium excretion input comprises a rate, a concentration, or an amount. 
     
     
         10 . The fluid therapy system of  claim 1 , further comprising a user interface, wherein the controller is configured to obtain the sodium excretion input for the patient from a user input via the user interface. 
     
     
         11 . The fluid therapy system of  claim 1 , further comprising a sensor configured to detect a level of sodium in the urine output from the patient, wherein the controller is configured to obtain the sodium excretion input for the patient based at least in part on the level of sodium detected via the sensor. 
     
     
         12 . The fluid therapy system of  claim 1 , wherein the controller is further configured to:
 determine a desired sodium excretion rate for the patient based at least in part on the adjusted urine output rate; and   cause (i) the diuretic to be administered to the patient at the one or more diuretic dosage rates and/or (ii) the hydration fluid to be administered to the patient at the one or more hydration rates to cause a sodium excretion rate for the patient to equal or exceed the desired sodium excretion rate.   
     
     
         13 . The fluid therapy system of  claim 12 , wherein the desired sodium excretion rate is a minimum sodium excretion rate associated with a net fluid loss goal for the patient. 
     
     
         14 . A method for providing fluid therapy to a patient, the method comprising:
 obtaining a urine output rate for the patient;   obtaining a sodium excretion input for the patient;   determining an adjusted urine output rate based on the sodium excretion input and the urine output rate, comprising—
 dividing the sodium excretion input by a predetermined urine sodium concentration to produce a weighted value, and 
 multiplying the weighted value by the urine output rate to determine the adjusted urine output rate; and 
   based on the adjusted urine output rate, (i) causing a diuretic to be administered to the patient at one or more diuretic dosage rates and (ii) causing a hydration fluid to be administered to the patient at one or more hydration rates to produce a net fluid loss in the patient.   
     
     
         15 . The method of  claim 14 , further comprising:
 determining one or more thresholds associated with the administration of the hydration fluid and/or the diuretic based at least in part on a ratio of the urine output rate to the adjusted urine output rate,   wherein causing the diuretic and the hydration fluid to be administered includes causing the hydration fluid and/or the diuretic to be administered, and/or causing an adjustment to the one or more diuretic dosage rates and/or the one or more hydration rates, based at least in part on the one or more thresholds.   
     
     
         16 . The method of  claim 14 , wherein the predetermined urine sodium concentration is at least 140 mmol/L. 
     
     
         17 . The method of  claim 14 , wherein
 the predetermined urine sodium concentration is a predetermined urine sodium concentration for a group of patients.   
     
     
         18 . The method of  claim 14 , wherein determining the adjusted urine output rate further comprises:
 determining the sodium excretion input is greater than a max threshold urine sodium level, and   using the max threshold urine sodium level as the sodium excretion input for the purpose of determining the adjusted urine output rate.   
     
     
         19 . The method of  claim 14 , wherein determining the adjusted urine output rate further comprises:
 determining the sodium excretion input is less than a minimum threshold urine sodium level, and   using the minimum threshold urine sodium level as the sodium excretion input for the purpose of determining the adjusted urine output rate.   
     
     
         20 . The method of  claim 14 , wherein causing the hydration fluid to be administered to the patient at the one or more hydration rates comprises:
 before receiving the sodium excretion input, causing the hydration fluid to be administered to the patient at a hydration fluid infusion rate; and   after receiving the sodium excretion input, causing an adjustment to the hydration fluid infusion rate based on the adjusted urine output rate.   
     
     
         21 . The method of  claim 14 , wherein causing the diuretic to be administered to the patient at the one or more diuretic dosage rates comprises:
 before receiving the sodium excretion input, causing the diuretic to be administered at a diuretic dosage rate; and   after receiving the sodium excretion input, causing an adjustment to the diuretic dosage rate based on the adjusted urine output rate.   
     
     
         22 . The method of  claim 14 , wherein obtaining the sodium excretion input comprises obtaining a rate, a concentration, or an amount associated with a level of sodium in the patient's urine. 
     
     
         23 . The method of  claim 14 , wherein obtaining the sodium excretion input includes obtaining the sodium excretion input from a user via a user interface. 
     
     
         24 . The method of  claim 14 , wherein obtaining the sodium excretion input incudes obtaining the sodium excretion input via a sensor configured to detect a level of sodium in the patient's urine. 
     
     
         25 . The method of  claim 14 , further comprising:
 determining a desired sodium excretion rate for the patient based at least in part on the adjusted urine output rate;   wherein—
 causing the diuretic to be administered to the patient at the one or more diuretic dosage rates includes causing the diuretic to be administered at one or more diuretic dosage rate to produce the desired sodium excretion rate; and/or 
 causing the hydration fluid to be administered to the patient at the one or more hydration rates includes causing the hydration fluid to be administered at one or more hydration rates to produce the desired sodium excretion rate. 
   
     
     
         26 . The method of  claim 25 , wherein the desired sodium excretion rate is a minimum sodium excretion rate associated with a net fluid loss goal for the patient.